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New Year, new rules. Maryland diabetics won’t have to break the bank for insulin in 2023

A patient holds a vial of insulin during a news conference in 2019.
Carlos Osorio/AP
A patient holds a vial of insulin during a news conference in 2019.

Hundreds of thousands of Maryland residents with diabetes will have one less thing to stress about in the New Year: the volatile cost of insulin, a lifesaving medication that enables chronically ill people with diabetes to keep their blood sugar in a safe range. That’s because new laws at the state and federal level cap the price of insulin for patients who are covered by Medicare and those with commercial insurance policies. In August, Congress passed the Inflation Reduction Act, a wide-ranging law that mandates all individuals covered by Medicare won't pay more than $35 for a month’s supply of insulin, or $420 each year.

Maryland diabetics are expected to experience an even deeper discount for insulin medication at the pharmacy counter.

In April, the Maryland legislature passed the Insulin Cost Reduction Act. Outgoing Gov. Larry Hogan signed the bill one month later.

Maryland’s new state law caps the patient cost for a 30-day supply of insulin to $30 or below, even for patients with private commercial insurance plans often through an employer.

The most common type of medical insurance coverage nationwide is a private commercial plan with costs shared between an employer and employee.

Medicare is a public health insurance program overseen by the federal government for qualifying residents often 65 years old and older. Medicaid is a health insurance program jointly managed by federal and state government for low-income individuals typically younger than 65 years old. Some Americans, often self-employed individuals, purchase Affordable Care Act exchange health insurance plans as an extension of the commercial market.

Prince George’s County Democrat and state Delegate Joseline Peña-Melnyk was the chair on the state committee that wrestled with early versions of the new Maryland law.

Peña-Melnyk has been a state delegate for the past decade representing District 21 which includes some of Prince George’s and Anne Arundel counties.

“The new year is bringing important new financial relief for Marylanders who use insulin,” said Peña-Melnyk, chair for the Maryland House of Delegates Health and Government Operations Committee. “Even one instance of insulin rationing can have devastating effects, and we look forward to this law going into effect on January 1st so that many Marylanders are able to ensure they have access to the life-saving medications they need.”

There are roughly 623,000 people in Maryland with diabetes, roughly 12.6% of the state population of 6 million, according to the American Diabetes Association. Inside that figure, roughly 156,000 are diabetic but are not formally diagnosed. More than 1.6 million Maryland residents are estimated to be pre-diabetic and each year tens of thousands of individuals statewide are diagnosed with the chronic disease.

Many diabetics nationwide who rely on insulin to live have struggled to pay sometimes sky high prices to pharmaceutical manufacturers, even with health insurance. Insulin costs have increased 600% in a 20-year period,according to a September report from NPR.

In 2019, the international consulting giant the RAND Corporation compared the price of insulin in the U.S. to other nations around the globe and found that insulin prices were “astronomically” higher than other countries.

The average cost for one insulin vial in the U.S. was $98.70 in 2018. The next most expensive nation was the Latin American country of Chile where patients pay $21.48 on average per vial of insulin.

“The average price in America, across all types of insulin, was more than ten times higher than the average for all of the other countries combined,” according to the RAND study.

Regulators in the District of Columbia in addition to states such as Virginia and West Virginia already have laws on the books restricting out of pocket copays for insulin.

Vincent DeMarco, president of Health Care For All, a consumer lobbying group that advocates for drug affordability, said the two new laws are a win for Americans with diabetes.

“Marylanders will now be able to afford their insulin when they could not before and that is lifesaving,” he said. “It will also help people be able to afford other things they need in their life besides their necessary drugs.”

Scott is the Health Reporter for WYPR. @smaucionewypr
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